Association Affairs Consultant II, Remote

WebTPA

18h • Remote

About The Position

This role will provide critical support to GuideWell's Inter-Plan Executive Office with a dedicated focus on Blue Cross Blue Shield Association/Inter-Plan Programs Compliance and Executive Escalations. The initial immediate focus and primary accountability of the critical role will be on facilitating resolution of BCBSA Inter-Plan Executive Escalations. The work scope includes escalations for all GuideWell-owned Blue Branded entities (e.g., Florida Blue, Triple-S, Florida Health Care Plan, Capital Health Plan) and non-Blue branded entities who perform Blue functions on GuideWell’s behalf (e.g., WebTPA). Escalations can be outgoing (GuideWell-escalated), or incoming (escalated from another Blue Plan or the BCBSA).

Requirements

• 4+ years related work experience.
• Related Bachelor’s degree or additional related equivalent work experience.
• Project management skills with experience leading or supporting projects.
• Solid understanding of the health insurance industry.
• Ability to communicate effectively with internal and external business partners and leaders.
• Experience with identifying, defining and resolving issues utilizing strong problem solving skills.
• Experience with PC office software such as SharePoint and MS Office applications (e.g. Outlook, Word, Excel and PowerPoint).
• Ability to support or lead integration planning with stakeholders.
• Flexible with the ability to coordinate and handle multiple deliverables/priorities within strict deadlines and timelines; Prioritizes and refocuses work efforts with minimal direction to accomplish goals.
• Knowledge of standard PC office software, such as and MS Office applications (e.g. Outlook, Word, Excel and PowerPoint).

Nice To Haves

• SharePoint utilization
• BCBS experience

Responsibilities

• Identify risks, evaluate controls and prepare findings and recommendations.
• Implement compliance programs to prevent illegal, unethical or improper business practices.
• Perform audits to ensure the organization’s programs are consistently administered in compliance with organizational policies and procedures, contractual obligations, rulings, laws and government regulations.
• Monitor and evaluate the effectiveness of solutions, policies, practices and processes to ensure continuous improvement, good client relations and adherence to business requirements. Recommend and support implementation of improvements to achieve and deliver high quality, value-added services.
• Develop, implement, administer and revise policies, procedures and programs that meet business needs; assist and/or lead program development and enhancements.
• Research, analyze, maintain, modify, validate and prepare data, information and content used in making business decisions. Present findings and articulate results.
• Produce, edit and distribute a variety of business documents such as reports, proposals, policies, procedures, audit results, issue papers, marketing materials, newsletters, brochures, etc. to internal and external audiences.
• Participate on or lead departmental and/or divisional projects. Plan, organize, monitor and control projects to ensure the effective use of resources and adherence to project management standards and reporting requirements.
• Support or participate on Enterprise wide workgroups and initiatives.
• Serve as a liaison between internal clients and the BCBS Association and Blue Plans; help customers achieve their objectives by serving as a subject matter expert or resource in the interpretation, application and compliance with BCBSA regulations, policies, procedures, standards and practices.
• Identify, develop, and build key internal partnerships to improve communication, coordination, collaboration and effective working relationships within own department and across the Company.
• Support assigned function at external hearings, mediations, audits, meetings, etc.
• Create, present and/or facilitate meetings, webinars, conference calls, training programs, education sessions, certifications, etc. for internal and external audiences.
• May mentor and coach less experienced coworkers on the technical and interpersonal skills needed for effective job performance.

Benefits

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, short- and long-term disability programs
• Leave programs to support personal circumstances
• Retirement Savings Plan including employer match
• Paid time off, volunteer time off, 10 holidays and 2 well-being days
• Additional voluntary benefits available
• A comprehensive wellness program
• Competitive pay as well as opportunities for incentive or commission compensation
• Regular annual reviews with pay for performance considerations for base pay increases

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees